The association between breast cancer and pregnancy is defined as detecting
breast cancer during pregnancy or within one year after delivery.
The diagnosis is often difficult and delayed. It is based on clinical examination,
radiological exams (ultrasound and/or RM) and biopsy of the suspected lesion. The
staging examinations should be performed only if any change in therapeutic decisions
or clinical practice could be made or in the presence of a high risk of distant
metastases.
The treatment includes surgery, radiotherapy, chemotherapy, hormonal therapy and
molecular targeted therapy, and it should be as close as possible with the standard
protocols of non-pregnant patients and should be discussed with a multidisciplinary
team. It is important to start the treatment as soon as possible, with the exception of
term pregnant patients, for whom it can be postponed after delivery.
The major fetal complications seem to be related to prematurity, and the type of
delivery depends on obstetrics indication. The delivery should be planned at least three
weeks after the infusion of chemotherapy, and the treatment generally could be
restarted one week after the cesarean section and immediately after a vaginal delivery.
The apparent poor outcome in pregnant women can be explained by the delayed
diagnosis and/or treatment and the biological characteristics of the tumor (often of high
grade and triple negative).
Finally, when the treatment is planned, reproductive counseling should always be
proposed to young patients immediately after diagnosis in order to plan the best fertility
preservation strategies
Keywords: Biopsy, BRCA mutation, Breast cancer, Breastfeeding, Chemotherapy, Delivery, Fertility preservation, Histological type, hormone therapy, Lymph nodes metastases, Magnetic resonance, Mammography, Multidisciplinary team, Pregnancy, Prematurity, Prenatal care, Radiotherapy, Surgery, Survival, Ultrasound.
